What is nerve pain?
Pain is a normal part of life. It protects us by providing a warning of imminent or actual harm. It forces us to rest the strained ankle or broken arm, preventing further damage and allowing the healing process to begin. Once we are healed, the job is done, so the pain disappears.
Nerve pain (or 'neuropathic pain') is different. It is a complex, usually chronic condition, where the normal pain processes are interrupted and the pain persists long after the original injury has healed. Burning, shooting, crawling, stabbing, shocking or freezing ... the pain is difficult to describe, and is different for each person, but it is real and can be constantly present. It is challenging to live with constant pain. Pain is invisible, which makes it difficult to convey to others what it is like to live with, and just how much it affects your life. It can have a major impact on your physical and mental wellbeing.
How common is nerve pain?
One in five Australians will suffer chronic pain in their lifetime and around one in six of those will suffer from neuropathic pain. The majority of people will need medicine and support to help them cope with their condition.
What causes nerve pain?
Nerve pain is produced by a range of disorders that lead to nerve damage or dysfunction in the peripheral (nerves in your face, arms, legs and body) and the central (brain or spinal cord) nervous systems. This nerve damage leads to the production of incorrect signals, as well as a changed perception of the pain. For example, changes occur that mean pain is still felt even after an injury has healed. You may even become more sensitive to pain after nerves regrow and form new connections causing simple actions, such as putting on socks, to become extremely painful.
Nerve pain may be felt within days of an injury, or can instead take months to develop and be diagnosed. Problems can also be triggered by even slight damage to nerves or previously healed injuries.
While there are numerous conditions that can lead to nerve pain, it is not always possible to pinpoint the exact cause.
How do I know if I have nerve pain?
'Nerve pain' is a term used to describe a collection of symptoms, rather than being a single problem that can be diagnosed. Because of this, no one 'standard' test exists to diagnose nerve pain, so an initial diagnosis relies heavily on your description of the pain along with a physical examination by a doctor.
Your doctor will ask you questions about how and when you experience pain along with questions about your medical history, including whether you have had illnesses such as shingles, physical injuries or recent surgery.
Your doctor will examine you physically to check for painful and non-painful areas. These basic tests may include:
- lightly stroking the skin to detect any painful responses
- pin-prick testing to check for numbness or over-sensitivity
- testing your ability to distinguish between cold and warm objects.
An initial diagnosis of nerve pain can usually be made by your doctor from a combination of your medical history, pain description and your responses to physical testing. However, further testing may be carried out to confirm the diagnosis, and may include:
- blood testing
- nerve conduction studies to assess how well the nerves are functioning
- computed tomography (CT) scans or magnetic resonance imaging (MRIs) for any structural damage or compression problems
- nerve biopsies to assess any nerve fibre abnormalities.
Nerve pain can be difficult to treat, and is often unresponsive to many forms of pain relief. This may mean that you will try several different treatments before discovering which ones produce the best results for you.
Keeping in mind that nerve pain is not easily treated, the main goals of treatment are to reduce the amount of pain you experience, help you to manage any remaining pain, minimise the impact on your quality of life, and control any underlying causes of your pain, such as diabetes.
There are different types of medicines available that may help you to manage your pain. You may also try some alternative therapies such as physiotherapy, massage or accupuncture - alone or in combination with medicines to find the treatment option that best suits you.